Mandible Fractures. Symphysis Fractures

Mandible fractures are common and are some of the most enjoyable operations I perform. I prefer to treat many mandible fractures with open reduction and internal fixation, followed by a short course of intermaxillary fixation with Synthes, IMF screws.

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Mandible Fractures

Mandible fractures are common. Typically, mandible fractures are best treated with open reduction and internal fixation (ORIF). ORIF involves using plates and screws to hold the fracture in position. This fixation allows arch bars or intermaxillary fixation to be removed sooner and allow the patient to use their jaw in a timelier manner.

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Facial Fractures. Mandible Fractures

Mandible fractures or jaw fractures are a common occurrence. Fractures of the mandible are analogous to fractures of the pelvis in that fractures often occur in more than one location.

Depending on the textbooks that one reads, the frequency of occurrence of most mandible fractures is as follows: body (29%), condyle (26%), angle (25%), symphyses (17%), ramus (4%) and coronoid process (1%).

I prefer to treat most mandible fractures with open reduction and internal fixation with plates and screws as this affords the patient a more rapid return to jaw mobilization and can prevent stiffness at the temporomandibular joint.

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Facial Fractures. Journal of Craniofacial Surgery

Pediatric Facial Fractures: Current National Incidence, Distribution, and Health Care Resource Use. Vyas, Raj M. MD; Dickinson, Brian P. MD; Wasson, Kristy L. BA; Roostaeian, Jason MD; Bradley, James P. MD
Journal of Craniofacial Surgery. 19(2):339-349, March 2008.

Zygoma Fractures, Orbital Fractures, Maxillary Fracture

Fractures of the zygomaticomaxillary complex frequently occur in concert with fractures of the orbital floor and orbital rim. Access to the these fractures is afforded thr0ugh exposure via the conjuntival incsion of the eye, the maxilary gingivobuccal sulcus, a lateral canthal extesion, and occasionally small access incisions on the cheek. Compliance post-operatively for the treatment of these fractures requires elevation of the head of bed to prevent edema, pain control, soft diet, and rest.

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Facial Fractures. Nasal Bone Fractres

Nasal bone fractures are the most common types of facial fractures. Often in the emergency room the physician will examine the septum of the nose to make sure there is no septal hematoma. If the nasal bone fracture produces a deformity, then the plastic & reconstructive surgeon to performs closed or open reduction usually between 3 and 7 days, and up to 2 weeks after the injury. If possible and if the surgeon has the opportunity, appropriate reduction of the fracture can occur within the first several hours following the injury before significant edema has appeared. It is quite common following nasal trauma for patients to have airway obstruction and often necessitate airway surgery or corrective rhinoplasty approximately 6 months following their injury.

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Facial Fractures. Zygomaticomaxillary Complex Fractures.

Zygomaticomaxillary fractures are common. Typically, these fractures occur when a person's head strikes the head, fist, or other solid object. The zygoma which protrudes a greater distance than the globe absorbs the impact at the expense of the eye.

Appropriate and optimal treatment of these fractures occurs within the first week of injury before the fracture has time to heal in incorrect alignment. Access if often gained to the inside of the orbit to ensure that the lateral orbital wall is correctly aligned.

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